Suter P M
Department of Medicine, Medical Policlinic, University Hospital Zürich, Switzerland.
Handb Exp Pharmacol. 2005(170):231-61. doi: 10.1007/3-540-27661-0_8.
The most widely spread eating habit is characterized by a reduced intake of dietary fiber, an increased intake of simple sugars, a high intake of refined grain products, an altered fat composition of the diet, and a dietary pattern characterized by a high glycemic load, an increased body weight and reduced physical activity. In this chapter the effects of this eating pattern on disease risk will be outlined. There are no epidemiological studies showing that the increase of glucose, fructose or sucrose intake is directly and independently associated with an increased risk of atherosclerosis or coronary heart disease (CHD). On the other hand a large number of studies has reported a reduction of fatal and non-fatal CHD events as a function of the intake of complex carbohydrates--respectively 'dietary fiber' or selected fiber-rich food (e.g., whole grain cereals). It seems that eating too much 'fast' carbohydrate [i.e., carbohydrates with a high glycemic index (GI)] may have deleterious long-term consequences. Indeed the last decades have shown that a low fat (and consecutively high carbohydrate) diet alone is not the best strategy to combat modern diseases including atherosclerosis. Quantity and quality issues in carbohydrate nutrient content are as important as they are for fat. Multiple lines of evidence suggest that for cardiovascular disease prevention a high sugar intake should be avoided. There is growing evidence of the high impact of dietary fiber and foods with a low GI on single risk factors (e.g., lipid pattern, diabetes, inflammation, endothelial function etc.) as well as also the development of the endpoints of atherosclerosis especially CHD.
最普遍的饮食习惯的特点是膳食纤维摄入量减少、单糖摄入量增加、精制谷物产品摄入量高、饮食中脂肪成分改变，以及以高血糖负荷、体重增加和身体活动减少为特征的饮食模式。在本章中，将概述这种饮食模式对疾病风险的影响。没有流行病学研究表明葡萄糖、果糖或蔗糖摄入量的增加与动脉粥样硬化或冠心病（CHD）风险的增加直接且独立相关。另一方面，大量研究报告称，致命和非致命性冠心病事件的减少与复合碳水化合物（即“膳食纤维”）或特定富含纤维食物（如全谷物谷物）的摄入量有关。似乎摄入过多的“快速”碳水化合物[即具有高血糖指数（GI）的碳水化合物]可能会产生有害的长期后果。事实上，过去几十年表明，仅低脂（进而高碳水化合物）饮食并不是对抗包括动脉粥样硬化在内的现代疾病的最佳策略。碳水化合物营养成分的数量和质量问题与脂肪问题同样重要。多条证据表明，为预防心血管疾病，应避免高糖摄入。越来越多的证据表明，膳食纤维和低GI食物对单一风险因素（如血脂模式、糖尿病、炎症、内皮功能等）以及动脉粥样硬化尤其是冠心病终点的发展具有重大影响。
